Give pt 1 can of beer w/each meal

elkpark · Jul 15, 2009

There's a big difference (legally) between ETOH and illiticit drugs. However, while no one is going to ask you to "shoot heroin" into your client's IV line, I've seen lots of addicted clients maintained on legal opioids or benzos while hospitalized. Clients have the right to refuse detox, same as they have the right to refuse any other treatment, and, since untreated ETOH withdrawal is a life-threatening condition, it is medically indicated to prevent that by providing ETOH during hospitalization. Some docs used to use an ETOH IV drip, but that is more expensive and invasive than just providing po ETOH. Untreated benzo withdrawal is also life-threatening. Untreated opioid withdrawal is rarely life-threatening, but it's so miserable (and the withdrawing clients make everyone else so miserable) that many docs go ahead and provide what is necessary to keep them from going into acute withdrawal if they are not interested in detox and tx.

ChristyRN2009 · Jul 15, 2009

I don't give my CHF patients or Diabetic patients tons of water or candy, but these are things that can be obtained by the patient quite easily. Just go to the sink or vending machine. Unfortunately they can't get a beer so that's where I come in on the occasion where the doctor deems it necessary. I don't have a problem with morally in the sense that I don't want to do it, like I said prior, it just bothers me in that it reinforces that people rarely change. And as far as the CHF/DM patient, they rarely change either, let's face it. I do what I can, educate when I can, and leave the rest to the patient, otherwise I'd go crazy.

blondnursey · Jul 15, 2009

LTC pts are there till they die.

it is their HOME.

they have the RIGHT, with md approval, to have a few beers or glass of wine.

QUALITY OF LIFE.

Tait, MSN, RN · Jul 15, 2009

LTC pts are there till they die.
it is their HOME.
they have the RIGHT, with md approval, to have a few beers or glass of wine.
QUALITY OF LIFE.

Well I think the main argument here needs to be divided into acute and LT care facilities. I work acute, therefore my opinion is going to be different from LTC.

Tait

blondnursey · Jul 15, 2009

family will probably sneak it in to acute....or pt will be trying to drink mouthwash etc..

the things family sneak in...lol

casi, ASN, RN · Jul 15, 2009

If the patient is in acute care for a broken leg and not DTs why put them through the DTs if they don't want to detox? It should be the patient's choice whether or not they abstain from alcohol or not.

Virgo_RN, BSN, RN · Jul 15, 2009

A couple of years ago, there was a doctor new to our facility who ordered for a ETOH dependent pt to receive 1 can of beer TID w/each meal. The nursing staff got a good laugh about it, but another nurse told us that some facilities give their patients beer to prevent withdrawal symptoms. Is this common in other hospitals? Or used to be common, but resorted to ativan instead? Some nurses say we might as well give them beer since when they leave the hospital, they'll be drinking anyway. But others think that it's going to make it worse for the pt since most alcohol dependent individuals drink more than 3 beers a day and it would cause more agitation by "teasing" them. I'm just very curious as to know how other hospitals handle their ETOH dependent patients.

Most ETOH dependent patients who come to my facility (acute care) are put on ETOH Withdrawal Protocol. Occasionally we do have patients who are ordered a glass of wine, a can of beer, or a shot of whiskey with dinner or at HS. These patients are typically geriatric patients who live in LTC and have this ordered there.

When I am a LOL in the hospital, I hope my doctor orders my HS glass of wine.